2026 Project Santa Application
Was your household approved for any of the following WIRC programs between October 2025 and today? (Please choose all that apply).
*
Yes, I was approved for LIHEAP.
Yes, I was approved for Good Food Pantry.
Yes, I was approved for Weatherization or Housing Rehab.
Yes, I was approved for Care Market (hygiene program).
No, I did NOT get any of those services from WIRC during that timeframe.
Something else
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How many years have you lived at that address? (Choose one).
*
I have lived there 5 or more years.
I have lived there between 1 to 4 years.
I have lived there for only a few months or less.
I do not have stable housing and/or am living at a temporary shelter.
What county do you live in?
*
Please Select
Hancock
Henderson
McDonough
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Which language are you most comfortable speaking? (Choose one).
*
English
Spanish
French
American Sign Language (ASL)
Other
How many children are you listing in this application?
*
Please Select
1
2
3
4
5
6
7
8
9
10
11 or more
Are any of the children you are listing in this application adults with a disability recognized by the government (for example, they get Social Security Disability)?
*
No
Yes
Do any of the children live part-time in another household? For example, you share custody with another parent. (This helps us to reduce duplication of services).
*
No
Yes
If you answered 'yes' to the question above, please explain. Otherwise, skip to the next question.
Please complete one row for each child. If you have fewer than 10 children, leave the remaining rows blank.
Rows
First & Last Name
Age
Gender
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Child 7
Child 8
Child 9
Child 10
If you have
more
than 10
children
, please call WIRC at 309-837-2997 or email
projectsanta@wirpc.org
.
What are your children's favorite toys, characters, or activities right now? Please list general interests only
*
Example: Spiderman; Pokémon; Swimming; Fidgets; Dinosaurs.
By checking the box below, I understand and agree that applying for Project Santa does not guarantee that my household will be accepted.
*
I understand and agree.
By checking the box below, I give WIRC permission to confirm my household's enrollment in other holiday gift programs. (This reduces the risk of duplicate services, so those programs can help as many children as possible).
*
I understand and agree.
Is this your first time applying for Project Santa?
*
Yes, it's my first time.
No, my kids got presents through Project Santa in the past.
Would you like to share why you are applying for Project Santa? (We may share your story with donors -- but we won't identify you or your children).
Submit
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